Owner's Manual: Is That a Crack or a Quack?

A look at chiropractics and its place in the running world

A deep breath, a quick twist and a gut-flipping, scalp-tingling pop: these are the essential elements of a trip to the chiropractor. Accompanied, for many, by profound relief from pain. Yet, many others are leery of the profession, citing unprofessional diagnoses and practices. Is a visit to the chiropractor right for you? If yes, what should you look for?

Chiropractics translates from Greek as “healing with the hands” and while its roots reach back to Ancient times, its formalized practice as we know it began in America in the late 19th century. It is a non-surgical, non-medicinal means of treating physical dysfunction through manual adjustment. Focusing largely on joints, chiropractors traditionally get these elements in their best working order by applied pressure. The most typical adjustment being those related to the spinal column where misaligned vertebra can cause painful flare-ups in the back, hips and other areas.

In the office of a chiropractor, these issues are addressed with the patient lying on a chiropractic table. Assuming a spectrum of poses from the mundane to the “pretzel like” the patient’s joints are manipulated by the doctor. Using “drop” panels throughout the table, the chiropractor maneuvers the body into prime position for the applied pressure and then works in concert with the solidity of the table. Pressing on or around the affected joint, the position, force and table all contribute to the joint slipping back into a more efficient attitude. This action is accompanied by a disconcerting pop as the changing pressure in the joint releases gas bubbles just like when knuckles are cracked. It takes some getting used to but can mean that relief is on its way.

“I’ve been going since 1993 when I was in High School,” says Olympic Silver Medallist Meb Keflezighi “now I try and get adjusted at least once every two weeks.” Keflezighi, like so many other elites, is finding that the restorative hands of a good chiropractor are a key factor in staying healthy. Though he first went with some trepidation, Keflezighi quickly came to believe in the practice. “What I like about chiro is that they look at the whole body, not just the injury. I might have pain in my hip but the problem might be in my shoulder.”

Getting chiropractic treatment is a growing trend among elite runners, says Dr. Ira Shapiro of Old Bridge, New Jersey, a three-time member of the US Olympic Committee medical team has been treating runners for the better part of two decades.

In addition to the three Olympic Games on his résumé, Shapiro recently worked the USATF Championships. "I will be busy from the moment I walk into the tent, until the last athlete leaves the compound," he says. "It's not the case of an isolated few taking advantage of my services; it's the vast majority."

Shapiro emphasizes a head to toe analysis of his patients that are symptomatic, watching them walk and sometimes run in and outside of his office. After years of experience, he can pick out structural problems that lead to typical running injuries in a single glance. “My daughters get sick of me in the mall because while they are looking to shop, all I see in the people walking by are problems waiting to happen.” His comprehensive analysis as to the reasons why an injury occurs is different, in Shapiro’s opinion, from how orthopedic doctors approach their patients. “They’re really looking at the bone, I’m looking at how the soft tissue and the bone interact.”

Like fine tuning a race car, chiropractic pre-race adjustments on an athlete can give them a winning edge. Aside from Keflezighi, Marla Runyan, Alicia Shay and Adam and Kara Goucher are among other elite runners who have benefited from chiropractic treatments.

“If you can increase the range of motion in a foot or ankle and that increase in motion benefits the athlete over 5K, that difference is exponentially increased over the event,” says Ted Forcum, an Oregon-based chiropractor and long time member of the US T&F medical team who has treated runners for everything from Morton’s neuroma to run-of-the-mill back pain. “Last year at the Nationals, I worked with a women’s 1500m runner with a groin injury right up until three minutes before the start of the race.” Due to the delicate nature of her issue, Forcum will not give the athlete’s name saying only that, “she did exceedingly well” that day.

Over the past decade, there have been a number of chiropractors focusing a segment of their business on the treatment of every day runners. Chiropractor Bob Irwin is a 2:34 marathoner from upstate New York, and he works with local running groups and high school track and cross-country teams. Says Irwin, “Because of the world we live in, there are a lot of symptomatic people out there because there’s so much sitting that goes on. People have weak cores and tight butts and hamstrings, not a world class set up for breaking records or even running injury free.”

To make up for our culturally inspired weaknesses, Irwin encourages people to come to him before they start a training program. An initial visit costs $150 and includes scans of the feet, testing for strength imbalances and an overall analysis of a runner’s posture. From this assessment, Irving then recommends a program for what the runner needs to do body-wise so they can perform at an optimal level. Sometimes this includes a “rack ‘em and crack ‘em” adjustment but frequently extends to a series of recommended stretches and exercises to account for the existing imbalances.